title: Dramatic decline in prevalence of Helicobacter pylori and peptic ulcer disease in an endoscopy-referral population.
abstract: OBJECTIVE
  To determine if endoscopic Helicobacter pylori and peptic ulcer disease prevalence has changed over an 11-year period in a rural region.
  
  
  METHODS
  Current endoscopic records were reviewed and compared with similar data obtained over a time period 11 years earlier at the same institution with regard to H. pylori status, endoscopic findings, microscopic pathologic findings, and medication use.
  
  
  RESULTS
  There were 251 records reviewed in the current study group (mean age 52.8 years, 59.0% female) and 263 in the previous group (mean age 60.1 years, 56.7% female). H. pylori was positive in 17 (6.8%) in the current study and 173 (65.8%) in the earlier study (P <.0001). Peptic ulcer disease (PUD) was present in 14 (5.6%) in the current study and in 102 (38.8%) in the earlier study (P <.0001). H. pylori was positive in 1 of the 14 PUD patients (7.1%) in the current study and in 78 of 102 (76.5%) in the previous study (P <.0001).
  
  
  CONCLUSIONS
  Endoscopic H. pylori prevalence in our rural locality has decreased substantially over the past decade and may reflect local overall prevalence trends, although underestimation is likely due to widespread prior noninvasive H. pylori diagnosis and treatment. Endoscopic PUD also has decreased precipitously, possibly related to changes in regional H. pylori characteristics and prolific use of antisecretory agents. Changing geographic trends regarding acid-peptic disease may prompt modification of diagnostic approach and treatment.
authors.affiliation: Department of Internal Medicine, West Virginia University Health Sciences Center, Charleston Division, 25303, USA. bmcjunkin@hsc.wvu.edu
authors.forename: Brittain
authors.initials: B
authors.lastname: McJunkin
authors.forename: Moussa
authors.initials: M
authors.lastname: Sissoko
authors.forename: Joel
authors.initials: J
authors.lastname: Levien
authors.forename: Jessica
authors.initials: J
authors.lastname: Upchurch
authors.forename: Ali
authors.initials: A
authors.lastname: Ahmed
mesh_terms: D000328:Adult; D000368:Aged; D015986:Confounding Factors, Epidemiologic; D016099:Endoscopy, Gastrointestinal; D005260:Female; D016481:Helicobacter Infections / Q000175:diagnosis / Q000453:epidemiology* / Q000382:microbiology; D016480:Helicobacter pylori / Q000302:isolation & purification; D006801:Humans; D008297:Male; D008875:Middle Aged; D010437:Peptic Ulcer / Q000382:microbiology*; D015995:Prevalence; D012017:Referral and Consultation; D012424:Rural Population / Q000706:statistics & numerical data*; D014903:West Virginia / Q000453:epidemiology